caa a22 4500 475780671 CHVBK 20180406123643.0 cr unu---uuuuu 170329e20000401xx s 000 0 eng 10.1007/s004640020014 doi (NATIONALLICENCE)springer-10.1007/s004640020014 Pain after microlaparoscopic cholecystectomy [Elektronische Daten] A randomized double-blind controlled study [T. Bisgaard, B. Klarskov, R. Trap, H. Kehlet, J. Rosenberg] Background: Laparoscopic cholecystectomy (LC) is traditionally performed with two 10-mm and two 5-mm trocars. The effect of smaller port incisions on pain has not been established in controlled studies. Methods: In a double-blind controlled study, patients were randomized to LC or cholecystectomy with three 2-mm trocars and one 10-mm trocar (micro-LC). All patients received a multimodal analgesic regimen, including incisional local anesthetics at the beginning of surgery, NSAID, and paracetamol. Pain was registered preoperatively, for the first 3 h postoperatively, and daily for the 1st week. Results: The study was discontinued after inclusion of 26 patients because five of the 13 patients (38%) randomized to micro-LC were converted to LC. In the remaining 21 patients, overall pain and incisional pain intensity during the first 3 h postoperatively increased in the LC group (n= 13) compared with preoperative pain levels (p < 0.01), whereas pain did not increase in the micro-LC group (n= 8). Conclusions: Micro-LC in combination with a prophylactic multimodal analgesic regimen reduced postoperative pain for the first 3 h postoperatively. However, the micro-LC led to an unacceptable rate of conversion to LC (38%). The micro-LC instruments therefore need further technical development before this surgical technique can be used on a routine basis for laparoscopic cholecystectomy. Springer-Verlag New York Inc., 2000 Key words: Gallbladder — Microlaparoscopic cholecystectomy — Pain — Randomized controlled trial nationallicence Bisgaard T. Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, DK-2650, Hvidovre, Denmark, DK aut Klarskov B. Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, DK-2650, Hvidovre, Denmark, DK aut Trap R. Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, DK-2650, Hvidovre, Denmark, DK aut Kehlet H. Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, DK-2650, Hvidovre, Denmark, DK aut Rosenberg J. Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, DK-2650, Hvidovre, Denmark, DK aut Surgical Endoscopy Springer-Verlag 14/4(2000-04-01), 340-344 0930-2794 14:4<340 2000 14 464 https://doi.org/10.1007/s004640020014 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640020014 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Bisgaard T. Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, DK-2650, Hvidovre, Denmark, DK aut NATIONALLICENCE 700 1- Klarskov B. Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, DK-2650, Hvidovre, Denmark, DK aut NATIONALLICENCE 700 1- Trap R. Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, DK-2650, Hvidovre, Denmark, DK aut NATIONALLICENCE 700 1- Kehlet H. Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, DK-2650, Hvidovre, Denmark, DK aut NATIONALLICENCE 700 1- Rosenberg J. Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, DK-2650, Hvidovre, Denmark, DK aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/4(2000-04-01), 340-344 0930-2794 14:4<340 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer